Out of the Blue
by sinnerforhire
Summary: They're in the middle of nowhere, Sam should have seen this coming, and Dean could die because Sam is a complete idiot. Sick!Dean.
1. Chapter 1

[A/N: Set between "Folsom Prison Blues" and "What Is and What Should Never Be."]

"Son of a motherfucking _bitch_!"

"Jesus Christ, Dean, keep it down. You're gonna get us kicked out." _And if I have to spend one more hour in the car with you, I'm gonna blow your brains out_, Sam says silently to himself. He doesn't know what got up Dean's ass this morning, but Dean's been unbearably bitchy all day. It's like a Tarantino movie without the bloodshed, and if Dean doesn't knock it the fuck off soon, there's gonna be some of that too.

Dean appears in the bathroom doorway, eyes flashing. "What did I tell you about moving my shit?"

"I didn't move anything. Your stuff's right where it always is."

"The fuck it is. I'm fucking sick of your bullshit, Sam."

"Dean." His voice is low, measured, dangerous; it's Dad's don't-fuck-with-me voice. Sam stands up, eyes narrowed. "Shut. The fuck. Up."

Dean rolls his eyes. "Who the fuck do you think you are, Dad? I don't take orders from you, you cocksucking son of a whore."

Sam always thought that "seeing red" was just an expression, like "green with envy." But no, it's actually possible. He charges forward, grabs Dean by the shoulders and shoves him up against the front door. "Get out."

"Get your motherfucking hands off me!" Dean grabs Sam's wrists and tries to twist free, but Sam holds him firmly in place.

"I don't care where you go or what you do, but if you come back before 4 o'clock, I swear to God I will put a bullet in your brain. Do you hear me?"

Dean says nothing, just gives him a look that would make a normal person piss his pants. "Fine," he grates out, jaw clenched tight. "Gimme my fucking keys."

Sam lets go of Dean and takes a step backwards. He leans over and snags the keyring from the dresser. Dean adjusts his shirt and grabs the keys out of his hand. Dean leaves without a word. Sam locks the door behind him and takes a few deep breaths, trying to get his heart rate down. They haven't fought like this since they were teenagers. It's been a long couple of months, though, and Sam's still not quite over the whole going-to-jail thing. Not to mention the FBI's-most-wanted thing.

He needs a distraction. He turns on the TV and finds _Fellowship of the Ring_ just starting on one of the cable stations. He makes a conscious effort to shut his brain off and lets himself get caught up in the adventures of the hobbits.

When his cell phone rings with Dean's ringtone at 3:15, he doesn't answer it. He thinks about shutting it off completely but doesn't. When it rings again 5 minutes later, he picks it up at the last possible second.

"This better be good."

"Sammy?" It's a 180-degree difference from earlier. Dean's voice is tentative, soft, even childish. Something's wrong. Sam turns off the TV.

"Are you okay?"

"Um...sort of?"

Sam sits up straighter. "Where are you?"

"I, uh...I don't know." It's so soft Sam has to strain to hear him.

"What's the last town you passed?"

"I'm not sure...I...I didn't see it."

Sam's eyes widen. "What do you mean, you didn't see it? What happened? What's going on? Are you hurt? Did something attack you? Where's the car?"

"I'm in the car," Dean replies, and it's the surest he's sounded so far. "But I don't know where I am, and I don't know how I got here, and my head hurts really bad and everything's kinda blurry."

Sam jumps up, swallows past the lump in his throat, and turns on his laptop. "Okay, I'm gonna tag the GPS in your cell phone and then I'm gonna come get you." _And take you to the fucking hospital_. "So just hang in there, okay? I'll be there as soon as I can."

"Okay." Dean's voice cracks, making him sound even more like a child. "Can you hurry? I don't like this."

"I will, Dean. Just hold on." He clicks the mouse button on the computer, brings up the website he needs. "I gotta go, but I'll call you back, okay?"

"You promise?"

"I promise," replies Sam. "I'll call you back in five minutes. Just sit tight, and keep the doors locked. You can do that, right?"

"Yeah."

"Okay, I'm gonna hang up now." Sam can barely get the words out around the huge lump in his throat. "Bye, Dean."

It takes a few seconds, but finally Sam hears him say, "Bye, Sammy."

x0x0x

After a 15-minute drive that should have taken 25, Sam finds the Impala parked on the narrow shoulder of a deserted country road. He pulls the station wagon he "borrowed" in behind it and yanks the keys out of the ignition, tossing them on the passenger seat. He doesn't even bother to close the door after he gets out, just runs so fast to the Impala that he slides on some loose gravel and almost falls on his ass. Dean's curled up in the backseat, face buried in his arms; Sam can't tell if he's conscious or not. He bangs on the door to see if he can get a reaction. Dean startles, then reaches up to unlock the door without even looking. Sam tries not to dwell on that. He throws the door open and kneels down. "Dean, are you okay?" Dean just groans and stays perfectly still. "I need you to look at me, Dean, okay?" Dean says something, but it's muffled and too low to make out. Sam grasps Dean's arm and pulls it away from his head. The pain is written all over his face--his eyes are squeezed shut, his jaw is clenched so tight it's trembling, and his eyebrows are practically touching. Sam's stomach clenches. Dean has the highest pain tolerance of anyone he knows and he's in fucking agony. This is bad. This is really bad.

Sam swallows hard. "I have to see your eyes, Dean. You have to open your eyes for me. I know it's gonna hurt like hell, but you gotta do it. Ten seconds, man, that's all I need."

"No," Dean whispers. "Please, no."

"I'm sorry." Sam moves to tilt Dean's head up so he can see and the strangled cry Dean lets out sends a chill down Sam's spine. He takes a deep breath and pries Dean's right eye open. The noise that comes from Dean's mouth sounds more like a wounded dog than a human. Fortunately--and thank God for small favors--the problem is immediately apparent. Dean's pupil is completely blown.

Aneurysm. He's having a fucking _aneurysm._ Sam suddenly realizes three things:

* they're in the middle of fucking nowhere,

* he should have seen this coming,

* and Dean could die because Sam is a complete fucking idiot.

Sam lets go of Dean's eyelid and allows him to cover his face again. "I'm calling 911. You just gotta hang on till they get here, all right? It's gonna be okay." Sam stands up, pulls his phone out of his pocket, dials it with shaking fingers.

"911, what's your emergency?"

"My brother's having an aneurysm. But we're pretty far out in the country, and he's really in bad shape."

"And you're on Valley Road?"

_Thank God for GPS_. "Yeah, I guess. We're not from around here."

"Well, you're only 10 minutes away from the nearest hospital. I'm dispatching EMS now."

10 minutes. It wouldn't sound like much normally, but in medical emergencies, things can change in a matter of seconds. Dean may not _have_ 10 minutes.

_Don't think like that_, he warns himself. _He's gonna be okay. He has to be_.

He _has_ to be.


	2. Chapter 2

Sam drops to his knees and gently lays a hand on Dean's arm. "Help's on its way. Just hold on a few more minutes, okay? You're gonna be fine. We'll get you to the hospital and they'll take care of you."

The noise Dean makes doesn't sound like assent. It sounds like pain and terror and it's fucking heartbreaking. Sam blinks back tears and rubs Dean's back. Dean's shirt is damp with sweat and his tense muscles quiver under Sam's hand. When he touches the base of Dean's neck Dean lets out a high-pitched keening moan that makes Sam's hair stand on end. Sam jerks his hand back like he's been burned. "God, Dean, I'm sorry, I didn't mean to," he stammers, words tumbling out in a panicked rush. He wants so badly to be a comfort to Dean but he just doesn't know what he can do that won't cause Dean more pain.

Then Dean uncurls, emits a short, sharp cry and goes into full-on convulsions.

"Shit, shit, fuck, no, please," Sam chants, staring in horror as Dean's body jerks and twitches uncontrollably. Dean's lying on his side on a soft surface, he won't hurt himself; there's nothing Sam can really do until the seizure stops. His extensive first aid training kicks in and he starts counting seconds in his head. At 60 his throat starts to feel tight. At 90 his stomach starts churning. He gets to 117 before Dean finally, blessedly, goes limp and Sam takes a breath for what seems like the first time in hours.

It's two more minutes before Dean stirs and makes a soft snuffling sound. Sam leans forward, reaches a hand up to block the bright afternoon sun. "Dean?"

"Hmmhn?" Dean's eyelids flutter. He finally pries them open with a supreme effort. There's no awareness in them; Sam's not even sure he can see anything. Or understand him. Or recognize Sam as his brother.

Sam hears the first hint of sirens in the distance. _Thank fucki_-- He can't finish the thought, because Dean starts gurgling and a small stream of liquid streams out of the corner of his mouth. Sam immediately shifts Dean forward and pries his jaw open. He doesn't even flinch when vomit drips over his hand onto the floor mat. He sweeps a finger through Dean's mouth, ensuring a clear airway. When he's satisfied that Dean's not going to choke to death, he grabs a rag from under the front seat and wipes his hand and Dean's chin clean. Then he pulls off his jacket, folds it and puts it under Dean's head. Dean murmurs something indistinct and lets his eyes fall closed. "I've got you," Sam says quietly, brushing Dean's hair off his forehead with a feather-light touch. The sirens are louder now, closer, and Sam lets the relief wash over him.

x0x0x

When the flashing red lights appear in Sam's peripheral vision and the siren peaks at an earsplitting level, Sam's so grateful he could cry. Dean doesn't so much as twitch; he's out for the count. Sam was desperately hoping it was sleep, not unconsciousness, that claimed Dean after the seizure, but luck hasn't gone Sam's way yet and it doesn't seem to want to start now.

The siren cuts out and the ambulance pulls to a halt in front of the Impala. The paramedics, a tall bald man and a black-haired girl who can't be more than 18, jump out and open the back doors. As they're gathering equipment, Sam fills them in. "He just had a seizure, it lasted about two minutes and he opened his eyes briefly but he wasn't responsive and then he vomited and he hasn't woken up since."

The girl puts her bag down and crawls in the back with Dean. She gives a steady litany of numbers and technical terms to her partner, and Sam knows just enough to know exactly how bad it is. They maneuver Dean onto the stretcher and strap him down; they're not even finished before he starts convulsing again. Sam can't do it, he can't watch Dean have another fucking seizure. He stumbles towards the car, grabs on to the door and uses it to hold himself up. Now that the ambulance is here, now that Dean is not solely his responsibility, Sam's starting to feel again, to drown in the guilt and horror and fear.

"Sir?"

Sam turns back with difficulty. He can't see Dean--they've already loaded him into the ambulance and shut the doors. "What?"

"We're ready to leave. You'll be following us?"

"Yeah." He leans over, sees the keys in the ignition. "I will."

"We're going to the Schuylkill Medical Center in Pottsville," she tells him. He nods and closes the back door of the Impala. She gets back in the ambulance. As he's sitting down in the driver's seat, the siren starts shrieking. He brings the car to life and peels out after the speeding ambulance.

*~*~*~*~*

Sam sits in the hard plastic chair and takes another sip of the sludge they call hospital coffee. Beside him, Dean lies motionless, buried under wires and tape and too many damn tubes. They have to stabilize him before they can cut his skull open and fix the aneurysm. The neurologist didn't pull any punches; he's not thrilled about Dean's chances. Even if he survives the surgery, there are all sorts of permanent, life-altering problems he could have. When Dean wakes up--if Dean wakes up--he might not be Dean anymore.

The nurse, a heavyset Latina about Dean's age, pushes the curtain aside. Sam doesn't even look up. Someone comes in every couple of minutes--students, interns, specialists, nurses, residents--and Sam's pretty sure that he's just a piece of furniture to them. He's fucking exhausted, would give anything to be able to go to a decent motel and sleep for about a year, but he's not leaving until Dean wakes up. Bobby's on his way, he promised to grab their stuff from the motel and bring it down.

The nurse bustles around the bed for a few more minutes, then leaves without a word. She comes back with some doctor or other, one he's not sure he's seen before. It's been several hours, though, so the night shifters might be on now. The doctor glances through Dean's chart, then presses some buttons on the ventilator.

"What are you doing?" he asks.

The doctor doesn't look at Sam. "Changing the settings. Stepping down from full assist to partial assist." He takes a step back, makes a note in the chart. "The goal is to get him off the machine by morning." He finally turns around and spares a glance at Sam. "Have you been here the whole time?"

"Yeah."

"No offense, son, but you look terrible. I'll put it to you straight: he's not going to suddenly wake up and be aware enough to know you're not here. Go home, get some food and water and 8 hours of sleep, and come back in the morning. If there's any significant change--for better or worse--we'll call you."

Sam knows the doctor's right. He can get a room in town, no more than a few minutes away, and come straight back if--God forbid--something should happen. The prospect of sleep is ridiculously appealing; it's been a long fucking day. He nods. "Okay."


	3. Chapter 3

Sam leans against the hood of the Impala and watches the LifeLion helicopter lift off. Dean's being transferred to a bigger, more prestigious teaching hospital for surgery. The doctors claim that he had a good night, that breathing unassisted is an encouraging sign, that his GCS score keeps improving, that his age and previous good health make his outlook better than most. But Sam looked up Dean's condition on the Internet, found out exactly what kind of long-term effects Dean might suffer: anything from fatigue and migraines to epilepsy, cognitive impairment and even another goddamn aneurysm. He looked at statistics and didn't like what he saw. Dean needs another miracle and Sam has no idea how he's going to make that happen.

"You about ready to head out, Sam?" asks Bobby from behind him.

Sam stands up. "Yeah."

"You sure you're okay to drive? No offense, kid, but you look done in."

"Dean'll freak if the car's not there when he wakes up," Sam replies.

"Dean'll freak more if you fall asleep at the wheel and wreck her," counters Bobby.

"It's an hour drive, I'll be fine." Sam pulls open the driver's-side door. "See you there."

The section of I-81 that stretches across Schuylkill County is as boring as they come. Aside from the shifts in elevation, nothing much changes for a good 40 miles. He's well into Lebanon County before the traffic starts to pick up and signs of civilization appear. He finds the hospital in Hershey easily enough and waits in the parking lot for Bobby to catch up.

An orderly takes them to the waiting room in Neurosurgery. It's a big, bright room with real couches and armchairs and a large, state-of-the-art coffeemaker. Dean's surgery is going to take the whole afternoon and the better part of the evening, so Bobby puts on a pot of coffee and they settle in to wait.

The room is silent for a long time. Finally Bobby speaks up. "It's not your fault, Sam."

"Yes, it is." Sam leans forward, clasps his hands and stares at the floor. "I thought he was just being an asshole. I should have known." He swallows hard and shakes his head. "I wasn't thinking. I was too busy being pissed at him. If I'd just figured it out sooner--"

"Sam." Bobby stands in front of him and tips his chin up, forcing him to meet Bobby's eyes. "Blamin' yourself ain't gonna help him any. You're no good to anyone if you let this thing keep eatin' at ya till you're sick too."

"It's what I deserve," mutters Sam, pulling away. "He's saved my ass more times than I can count, and the one time he needed me, I let him down. I fucked up, Bobby. I completely fucked up and now Dean's paying the price." Sam ducks his head so Bobby can't see the tears threatening to spill down his cheeks. "Just like always." He stands up. "I'm going for a walk. I'll be back."

Sam stalks blindly down the hall, not paying attention to anything but his whirlwind thoughts. Near the end of the hall, he bumps into a man in a trenchcoat. "Sorry," he mumbles without slowing down.

*~*~*~*~*

As night gives way to morning, Sam dreams.

He dreams that Dean is standing at the top of a hill. No matter how far Sam climbs, he never gets any closer to the top. When he finally falls, it's almost a relief. He wakes up to the sound of his own harsh breathing echoing in his ears.

It doesn't take a genius to figure out what his subconscious is trying to tell him. He yawns, lifts his head from where it's currently lying on Dean's bed, and tells his subconscious to go fuck itself. Dean will come back to him. He _will_.

He turns the bedside lamp to its lowest setting and looks at Dean. They had to shave his head for the surgery, but he's swathed in so many bandages that it's hardly noticeable. He's still pale, freckles standing out bright against his chalky skin. The lines of the oxygen cannula stretch across his cheeks, leaving thin shadows. His GCS score is good, the surgical sites show signs of healing--he's doing well. He should wake up anytime.

But he hasn't.

"Come on, Dean," he says quietly. He takes Dean's limp hand in his, gives it a gentle squeeze. "I'm holding your hand, dude. In public. When a hot nurse could walk in any time and see." He leans in. "Total chick-flick moment. You gonna just lie there and take it?"

Nothing.

Sam yawns again, rubs his aching neck, and goes back to sleep with Dean's hand still in his.

His next dream is jumbled, confusing, surreal; when he wakes up, all he can remember are the wings. Delicate, iridescent wings, seemingly too fragile to support any living creature.

He opens his eyes, but the blinding white light forces him to slam them shut again. He must have slept longer than he thought if the sun has already risen. There's a rush of warm air, a soft rustling sound, and then a light touch on Sam's forehead. As he slips into darkness, he feels strangely at peace.

*~*~*~*~*

_"It is done. The timeline has been restored."_

_"And the one responsible?"_

_"He has been...dispatched."_

_"Excellent."_

*~*~*~*~*

"Hey, man, how're you feeling?"

"Same as the last time you asked me that," Dean replies, rolling his eyes. "Thirsty, kinda stoned and dying for decent food."

Sam can't keep the grin off his face as he pours water into a paper cup. Dean takes it gratefully, his hand steadier than it's been the last two times he woke up. He finishes the water and hands the empty cup to Sam. "Did you get the paperwork?"

Sam sighs. "I still think this is a bad idea."

"Dude, come on. I'm goin' nuts here. You know how much I hate hospitals." He motions for Sam to give him more water.

"You almost _died_, Dean. You had a ruptured aneurysm, for fuck's sake. There's a hole in your skull. You're still on narcotics. For once in your goddamn life, can't you just suck it up and do what they tell you?"

Dean sags against the pillow. "All right, Sammy. If it's freaking you out that much, I'll stay." He drains the cup of water and sets it on the bedside table. "But you're getting me a fucking cheeseburger."

Sam grins. "Deal."


End file.
